Study looks at ways to keep doctors in rural areas

Rural states like Iowa have problems in getting doctors to come and stay in small rural communities. To find out which students are likely to set up and stick with a rural practice, University of Nebraska Medical Center Doctor Paul Paulman set out to study how they can train doctors to meet the needs of those rural areas.

Paulman says one of the things he’s interest is “We have to admit the right students, or students with the right characteristics, in order to have them be successful in smalltown practice.” He wonders what are the characteristics of a successful small-town Nebraska family physician. He’s known a number of those, when he was in private practice himself and through professional groups and associations, but he took it as a challenge to identify the ones who’d work out well when they were still just students.

With the help of a grant, he gathered a medical student who was interested in the topic and a team of research people and designed a set of questions to ask the doctors that would find out what characteristics make them successful in that environment.

They identified about eleven country doctors who’re remained in their practice and enjoyed it, instead of leaving for a big city or urban medical center. Two of the group surveyed were women, all had been in their practice five years or more. The researchers found some similar traits like each had “connections” to a rural community, having grown up or spent time there.

Also, they were all fairly independent-minded and service-oriented, they’re relationship-driven and believe they’re making a difference in their community. “I think there are some things that we found that could be helpful in our admissions process,” he says. He says teachers and counselors need to be aware of which high-school students are interested in health sciences, and he notes UNMC already has programs to give preference to students from some smaller colleges who are interested in going into medicine.

Still, he says local communities have to help “grow their own.” He says they need to support students headed to med school who have the family ties and other interest that could bring them back home to set up a practice. “All the medical schools are in the city,” he points out, and some students get married while they’re there. Some find they like life in the city and they won’t come back. He says that’s why rural states need to bring in more students at the front end, to make sure there are enough to come back and practice medicine in rural towns.